A pilot study to evaluate the effect of splanchnic nerve stimulation on body composition and food intake in rats.

BACKGROUND: Systemic sympathetic stimulation with caffeine and ephedrine increased metabolic rate, reduced food intake, and improved body composition but had systemic adverse events. We hypothesize that selective sympathetic stimulation of the upper gastrointestinal tract will preserve the advantages of systemic sympathetic stimulation without its adverse events. This study evaluated the effect of splanchnic nerve stimulation on metabolic rate, food intake, and body composition. METHODS: Sixteen Sprague Dawley rats had monopolar electrodes placed on the superior common splanchnic nerve innervating the celiac ganglia. An indifferent electrode was placed subcutaneously on the back. The animals were placed on a 60% fat diet, and eight rats were stimulated for 6 weeks. The stimulation was advanced over 3 days from 0.6 mA to 3 mA. Metabolic rate and food intake were measured daily; weight change was monitored weekly, and body composition was determined by nuclear magnetic resonance (NMR) at the end of the study. Four of the eight animals had metabolic rate measured three times over 2-day periods at 0 mA, 1 mA, and 3 mA of stimulation in a metabolic chamber. RESULTS: Except for the first week of stimulation, there was no difference in body weight between the stimulated and control groups. Cumulative food intake was less in the stimulated group (p<0. 001). The lean-to-fat ratio was greater in the stimulated group (p<0. 01), and the animals that received incremental stimulation showed significantly augmented metabolic rate (p<0. 02). CONCLUSIONS: Splanchnic nerve stimulation decreased food intake, increased metabolic rate, and improved body composition.

Stimulation of sympathetic innervation in the upper gastrointestinal tract as a treatment for obesity.

Sympathetic activity and obesity have a reciprocal relationship. Firstly, hypothalamic obesity is associated with decreased sympathetic activity. Caffeine and ephedrine increase sympathetic activity and induce weight loss, of which 25% is due to increased metabolic rate and 75% is due to a reciprocally decreased food intake. Secondly, hormones and drugs that affect body weight have an inverse relationship between food intake and metabolic rate. Neuropeptide Y decreases sympathetic activity and increases food intake and body weight. Thirdly, a gastric pacemaker Transcend and vagotomy increase the ratio of sympathetic to parasympathetic activation, decrease food intake, and block gut satiety hormones. Weight loss with the pacemaker or vagotomy is variable. Significant weight reduction is seen only in a small group of those treated. This suggests that activation of the sympathetic arm of the autonomic nervous system may be most important for weight loss. Systemic sympathetic activation causes weight loss in obese patients, but side effects limited its use. We hypothesize that selective local electrical sympathetic stimulation of the upper gastrointestinal tract may induce weight loss and offer a safer, yet effective, obesity treatment. Celiac ganglia delivers sympathetic innervation to the upper gastrointestinal tract. Voltage regulated electrical simulation of the rat celiac ganglia increased metabolic rate in a dose-dependent manner. Stimulation of 6, 3, or 1.5 V increased metabolic rate 15.6%, 6.2%, and 5%, respectively in a single rat. These responses support our hypothesis that selective sympathetic stimulation of the upper GI tract may treat obesity while avoiding side effects of systemic sympathetic activation.

Hypnosis and upper digestive function and disease.

Hypnosis is a therapeutic technique that primarily involves attentive receptive concentration. Even though a small number of health professionals are trained in hypnosis and lingering myths and misconceptions associated with this method have hampered its widespread use to treat medical conditions, hypnotherapy has gained relevance as an effective treatment for irritable bowel syndrome not responsive to standard care. More recently, a few studies have addressed the potential influence of hypnosis on upper digestive function and disease. This paper reviews the efficacy of hypnosis in the modulation of upper digestive motor and secretory function. The present evidence of the effectiveness of hypnotherapy as a treatment for functional and organic diseases of the upper bowel is also summarized, coupled with a discussion of potential mechanisms of its therapeutic action.

Influence of organ pathology on the electrical parameters in organ projection areas of the skin.

Pathology of an internal organ causes significant rectification of electrical currents (diode phenomenon) in related skin areas--organ projection areas (OPAs), once the resistance 'breakthrough effect' has been induced in the skin. Also, the impedance of the diseased organ's projection areas is increased. The aim of this double-blind study was to confirm these phenomena statistically using a broad spectrum of measuring parameters. Skin impedance vs. measurement frequency, skin impedance vs. applied voltage, and skin resistance vs. voltage were evaluated at 335 auricular OPAs related to the healthy internal organs and 203 auricular OPAs related to the diseased organs. These measurements confirmed that the skin electrical characteristics of specific locations are dependent on the health state of the corresponding internal organs. It was found that the impedance of OPAs corresponding to the healthy internal organs equals 185 +/- 291 komega at 10 Hz and decreases to 64 +/- 49 komega at 10 kHz; and that the impedance of OPAs related to the diseased organs equals 7.5 +/- 2.2 Momega at 10 Hz and 99 +/- 50 komega at 10 kHz. The disparity of the impedances between the healthy and diseased organs related OPAs is greater at higher potentials. The skin resistance, when measured with a negatively polarized point electrode, undergoes a rapid resistance decrease of approximately two orders of magnitude, if the applied current is sufficient. After this reversible 'breakthrough effect' is obtained the skin exhibits rectification. The degree of rectification is low for OPAs related to the healthy organs. For OPAs related to the diseased organs, the resistance measured with a positive polarisation of measuring electrode could be five times greater than the resistance measured at the same voltage with the same but negatively polarised electrode. The disparity between the resistance measured with a negatively and with a positively polarised electrode at OPAs related to the diseased organs was greater at higher measurement voltages. The influence of organ pathology on the electrical parameters of related OPAs does not depend on the kind of internal organ and is not affected by the etiology of pathology. The degree of rectification or difference in impedance is proportional to the extent of the pathological process within the related organ.

Concurrent RT with 5-FU/epirubicin and cisplatin or irinotecan for locally advanced upper GI adenocarcinoma.

From the results of recent studies, it is likely that multimodality therapy with chemotherapy and radiation treatment may improve the overall outcome of locally advanced upper gastrointestinal (GI) malignancies, including esophageal, gastric, pancreatic, and biliary tract carcinomas. However, more effective, more optimal, and less toxic chemotherapy regimen(s) with concomitant radiotherapy are needed beyond the concurrent continuous-infusion fluorouracil (5-FU) with radiation that is commonly applied in general practice. Epirubicin (Ellence), cisplatin, and irinotecan (Camptosar) are all active cytotoxic chemotherapy agents in upper GI cancers. Two phase I studies were designed to test the tolerability of the combination of radiotherapy with infusional 5-FU, epirubicin, and cisplatin (ECF) or 5-FU, irinotecan, and epirubicin (EIF) in the treatment of locally advanced upper GI malignancies.